Endometrial destruction by thermal coagulation: evaluation of a new form of treatment for menorrhagia

Objective To report the first clinical evaluation of a new balloon endometrial, thermal destruction system Cavaterm(TM), for outpatient treatment of menorrhagia. Design To elucidate possible technical problems during treatment, to evaluate how the patients tolerated the treatment and to judge which patients were suitable for this form of treatment. Main outcome measures Measurements of bleeding volumes in pads and tampons before and after treatment were performed as well as subjective evaluation by bleeding charts. Patients also estimated their degree of satisfaction. Setting Gynaecology department at a university hospital. Subjects 36 patients under 52 years of age with menorrhagia, without suspicion of intracavitary pathology including malignancy. Results No procedure-related complications occurred. The patients tolerated the treatment well. There was a significant reduction in measured bleeding volumes in pads and tampons, collected during one menstruation, 2-7 months after treatment compared with measurements before treatment. Four patients subsequently underwent hysterectomy and should not have been included in the study (two with pedunculated myoma and one with a septum; the fourth showed premalignant endometrial changes in the curettage preceding the treatment). At 18-28-month follow up, 29 of the suitable patients (91%) reported a significant reduction in bleeding and another three patients reported reduced but still profuse bleeding compared with pretreatment; 88% (28/32) rated the treatment results as excellent, and a further 9% (3/32) as good. Conclusions We found the Cavaterm(TM) system for endometrial destruction to be safe, efficient and easy to use.